Biomarkers of Gulf War Veterans' Illnesses: Tissue Factor, Chronic Coagulopathy, and Inflammation
Posted May 24, 2011
Ronald Bach, Ph.D., VA Medical Center, Minneapolis, Minnesota
Many veterans of the 1990-1991 Persian Gulf War suffer from unexplained chronic and often debilitating health issues. It is estimated that 25% to 32% of the nearly 700,000 Gulf War veterans currently experience widespread pain, headaches, fatigue, cognitive deficits, and other symptoms. Preliminary evidence has indicated that a high percentage of ill Gulf War veterans may be in a hypercoagulable state, i.e., an abnormally increased tendency toward blood clotting, the basis of which is unknown. Dr. Ronald Bach of the VA Medical Center in Minneapolis is using funds from an FY08 GWIRP Investigator-Initiated Research Award to further investigate this concept. Dr. Bach will examine the level of tissue factor (TF), the biological initiator of blood coagulation, in blood samples from ill Gulf War veterans and healthy controls. Overexpression of TF in the bloodstream can lead to disseminated intravascular coagulation (DIC) and impaired blood flow in the smallest of blood vessels. This restriction of microcirculation applied chronically can produce symptoms commonly associated with Gulf War Illness (GWI), including fatigue, somatic pain, and cognitive difficulties.1
Dr. Bach will initially try to find more evidence of clotting system abnormalities in ill veterans' blood by measuring an expanded panel of coagulation markers, including D-Dimer, which indicates fibrin clot formation, thrombin-antithrombin III complex (TAT), to indicate ongoing coagulation activity, prothrombin fragment 1.2 (F1.2), a measure of ongoing thrombin generation, and TF-procoagulant activity (TF PCA), which can initiate DIC. Serial samples taken over 24 months will be assayed to establish the chronic nature of the abnormalities. This analysis may also uncover new biomarkers for GWI. Dr. Bach will also assess immune function by measuring levels of inflammatory markers in the blood samples. This may indicate a possible state of chronic inflammation in ill veterans and may support a connection between chronic coagulation and immune function.
This study seeks to contribute to the understanding of GWI etiology. The results generated could identify a novel biomarker for the diagnosis of GWI, lead to clinical trials of therapies, and improve the health of veterans with GWI.
1 Hannan KL, Berg DE, Baumzweiger W, Harrison HH, Berg LH, Ramirez R, and Nichols D. 2000. Activation of the coagulation system in Gulf War Illness: A potential pathophysiologic link with chronic fatigue syndrome, a laboratory approach to diagnosis. Blood Coagulation and Fibrinolysis 11(7):673-678.